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Are Periodic Episodes Of Tachycardia Common While Having Pulmonary Hypertension?

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Posted on Fri, 13 Mar 2015
Question: If there is a possibility that you may have pulmonary hypertension , are perodic epsodes of tachycardia common? For the past 2 days my heart rate has ranged anywhere from 128 -143 once my body started to get tired and coughing became uncontrollable. However as of right now today my heart rate hasnt been much over 110 and heart hasn't felt like it was going to beat through my chest. Is this something i should bring up to my dr. On monday when i see her? What other things cause pulmonary hypertension? Do meds like phentermine and topamax aggregate or worsen pulmonary hypertension?
doctor
Answered by Dr. Tushar Kanti Biswas (2 hours later)
Brief Answer:
Pulmonary hypertension

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

There are many causes of pulmonary hypertension. It is a long list.
However pulmonary hypertension with episodic tachycardia is most commonly due to Left-sided atrial or ventricular heart disease or Left-sided valvular heart disease .Tachycardia may be due to intermittent atrial fibrillation or paroxysmal supraventicular tachycardia in such cases.
Persistent tachycardia may also be due to left heart failure.
You might have already undergone ECG and 2-D Echocardigram for evaluation of
pulmonary hypertension.
Phentermine can cause Primary pulmonary hypertension.
Topamax (Topiramate) is not known to cause or aggravate pulmonary hypertension.






Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Tushar Kanti Biswas (55 minutes later)
If i were to stop the phentermine will that take care of the s/s of pulmonary hypertension? Or once s/s are present does it require more agressive treatment? I did have complete cardiac work up done with heart echo and cardiologists said the s.o.b is not from my heart its my lungs which is what lead me to the pulmonolgist who stated really not sure what is going on and thinks it could be pulmonary hypertension.
doctor
Answered by Dr. Tushar Kanti Biswas (1 hour later)
Brief Answer:
Pulmonary hypertension

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
If you have developed symptoms and signs of pulmonary hypertension following phentermine use , you should forthwith discontinue phentermine .Pulmonary hypertension is likely to regress subsequently.
What was the pulmonary arterial blood pressure recorded on your 2-D Echocardiography?







Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Tushar Kanti Biswas (10 hours later)
Im not sure my cardiologists ever said if he tested for pulmonary arterial blood pressure, if he did he didn't ever talk about it. Is a 2 d echocardiography the same thing as a echocardiogram? If not what is the difference between them? Also I'm not for sur if my s/s were caused by the phentermine or not, i started taking phentermine for the first time about 3 yrs ago but after being on it for 6 mo i started to gain weight so dr switched me to adderall xr 60 mg aday for 3 yrs then was to expensive so went back to phentermine and added topamax which when taken together is same as new weightloss drug called cosemeea ( think i spelled it wrong) but is cheaper to separate them like my dr did for me. Been on them for about 5-6 mo.
doctor
Answered by Dr. Tushar Kanti Biswas (2 hours later)
Brief Answer:
Pulmonary hypertension-follow up query

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
2-D Echocardiography and echocardiogram are same.Echocardiogram is usually combined with color Doppler study which gives the information about various pressure recording including pulmonary arterial blood pressure.Normal pulmonary arterial blood pressure is 30/15 mm hg.
You have not elaborated your symptoms or signs.
The most common symptom attributable to pulmonary hypertension is exertional dyspnea. Other common symptoms are fatigue, angina pectoris, syncope, near syncope, and peripheral edema






Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Tushar Kanti Biswas (6 hours later)
The symptoms i have been dealing with for almost 3 mo is. Decreased breath sounds in lower right lung and unable to take in deep breaths because it hurts long with severe airway restriction and Chest discomfort which sometimes is very mild to feeling heavy or painfull along with S.o.b periodically, which tends to be more in late morning to early afternoon after my body tends to get tired or woren out, or after physically doing stuff. The coughing tends to be much worse at this point also which further aggregates the breathing and makes the chest discomfort worse. At verying time the pulse rate will be tachy in range of up to 140 and spo2 levels drop to around 93-95%. I hate use inhaler when all this is going on this bad cuz i know it will only increase my pulse rate, and when it is already at 140 I'm sure it not get any higher m sure its at an unsafe rate already at that point. By the time evening comes I'm completely woren out and and my chest is so tight feeling it hurts to breath. As time has gone on things gotten worse and inhalers are not working very well. Any advise will be great.
doctor
Answered by Dr. Tushar Kanti Biswas (2 hours later)
Brief Answer:
Go for pulmonary function tests & HRCT chest

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

You have some symptoms which can occur in pulmonary hypertension. It is also quite possible that you are having some primary lung disorders which can give rise to secondary pulmonary hypertension.

Go for pulmonary function tests & HRCT chest, if not already done.

However you need to discontinue phetermine and switch over to some other group of drugs for weight loss.







Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Tushar Kanti Biswas (58 minutes later)
I did have a pulmonary function test done nov. 20th 2014 it showed severe airway restriction. What is a hrct chest? What does it consist of?

By any chance could the 15 p.e i had between the bases of the lungs 12 yrs ago be causing my signs and symptoms i have described earlier? If so what do you do to correct the issue
doctor
Answered by Dr. Tushar Kanti Biswas (2 hours later)
Brief Answer:
high resolution computerized tomography of chest

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

HRCT chest stands for high resolution computerized tomography of chest.

HRCT gives detailed images of the lung parenchyma ( which is comparable to gross tissue inspection ) and thus allows detection of diseases at an earlier stages than conventional CT scan.

With high resolution CT scan’, the thickness of individual cross sectional images is approximately 1-2 mm (HRCT utilizes thin collination ),rather than the usual 10 mm (usually of 5-7 mm),

I could not follow what you want to convey by '15 p.e ' Please elaborate.


Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Tushar Kanti Biswas (8 hours later)
What my question was earlier was is there any chance that when i had 15 pulmonary embolisms between the bases of both lungs 12 years ago have caused damage to the lungs, and just now be causing or showing signs and symptoms of what i have been dealing with?
Also when I'm at work i most of the time put on a tough guy act and dont let others know that I'm having issues with s.o.b and chest discomfort and keep pushing my self until i cant take it any more should i be pushing myself to the limits like this or not? I dont want people to think great she's not goig to be much help today which is why i push myself as far as i can.
doctor
Answered by Dr. Tushar Kanti Biswas (1 hour later)
Brief Answer:
Recurrent pulmonary embolism(PE)

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.



Recurrent or Chronic pulmonary thrombo-embolism is a cause of Pulmonary hypertension .
Again HRCT chest will clarify the extent of damage or fibrosis in lungs due to PE.
You need to undertake any physical activity within limit of your tolerance and not to push yourself beyond the edge.Small works for short period probably will be better than working hard for a long stretch.


Regards

Dr. T.K. Biswas M.D. XXXXXXX
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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Are Periodic Episodes Of Tachycardia Common While Having Pulmonary Hypertension?

Brief Answer: Pulmonary hypertension Detailed Answer: Hi, Thank you for your query. I can understand your concerns. There are many causes of pulmonary hypertension. It is a long list. However pulmonary hypertension with episodic tachycardia is most commonly due to Left-sided atrial or ventricular heart disease or Left-sided valvular heart disease .Tachycardia may be due to intermittent atrial fibrillation or paroxysmal supraventicular tachycardia in such cases. Persistent tachycardia may also be due to left heart failure. You might have already undergone ECG and 2-D Echocardigram for evaluation of pulmonary hypertension. Phentermine can cause Primary pulmonary hypertension. Topamax (Topiramate) is not known to cause or aggravate pulmonary hypertension. Regards Dr. T.K. Biswas M.D. XXXXXXX